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目的为经口咽下颌骨劈开扩大入路提供解剖学依据。方法 6例新鲜成人头颈部标本,以模拟手术方式,依次行经口下颌骨劈开(保留舌体)和经口下颌骨、舌体劈开扩大入路解剖至颈髓,依次测量并记录两种入路的显露范围,探查性操作范围及重建性操作范围,测量双侧椎动脉相关解剖数据。结果两种扩大入路的显露角度分别为(63.67±3.50)°和(74.14±1.47)°。最大探查性操作范围分别为斜坡下1/3→C5上终板和斜坡下1/3→C6上终板,最大重建性操作范围分别为C2下1/2→C5上终板和C2下1/2→C6上终板。椎动脉距中线C2/3为(16.88±0.75)mm;C3/4为(16.48±1.47)mm,C4/5为(16.30±1.09)mm;距门齿垂直深度C2/3为(96.44±3.59)mm;C3/4为(97.94±4.51)mm,C4/5为(99.83±4.77)mm。结论经口咽下颌骨劈开扩大入路是处理张口受限和颈脊髓腹侧长节段病变的安全、有效的入路,需据手术范围确定是否劈开舌体。
Objective To provide an anatomical basis for the oropharyngeal mandibular cleft expansion. Methods Six fresh adult head and neck specimens were dissected and dissected to the cervical cord by means of simulated operation. The mandibular splitting (retaining the tongue) and the mandibular mandibular mouth were sequentially performed through the oral mouth, followed by measurement and recording of two The range of exposure, the scope of exploratory operation and the scope of reconstructive operation were measured, and bilateral anatomical data of vertebral artery were measured. Results The two revealed angles of enlargement were (63.67 ± 3.50) ° and (74.14 ± 1.47) °, respectively. The maximum exploratory operating range is 1/3 → C5 upper end plate and 1/3 → C6 upper end plate under the slope, respectively. The maximum rebuilding operation range is C2 lower 1/2 → C5 upper end plate and C2 lower 1 / 2 → C6 on the end plate. The mean C2 / 3 of the vertebral artery was (16.88 ± 0.75) mm from the midline; (16.48 ± 1.47) mm for C3 / 4 and (16.30 ± 1.09) mm for C4 / 5; (96.44 ± 3.59) mm; C3 / 4 was (97.94 ± 4.51) mm, C4 / 5 was (99.83 ± 4.77) mm. Conclusions The oropharyngeal mandibular cleft enlargement approach is a safe and effective approach to the treatment of limited mouth opening and long segment of cervical spinal cord ventral segment. It is necessary to determine whether to split the tongue according to the scope of the operation.